Our environments have a much greater impact on our health than we may think. Where we live, from the state to neighborhood-level, income, race, and many other factors impact diet, which is a crucial determinant for overall health.
Caitlin Caspi, an associate professor of allied health sciences in the College of Agriculture, Health, and Natural Resources, and director of food security initiatives at the Rudd Center for Food Policy & Obesity at UConn, has dedicated her career to studying policies and evaluating interventions to address food insecurity, obesity, and other diet-related health disparities. Caspi is also a researcher in UConn’s Institute for Collaboration, Health, Intervention and Policy (InCHIP).
Caspi studied psychology as an undergraduate at Brown University. After graduating, she worked as a research assistant at Memorial Sloan-Kettering Cancer Center in New York in clinical trials for end-stage prostate cancer.
During her time there, Caspi started thinking about how she wanted to apply her skills as a researcher.
“I was always interested in research, and I was always interested in health,” Caspi says. “At Memorial Sloan-Kettering, I put a lot of thought to where I wanted to be investing myself in the puzzle of addressing severe health problems like cancer.”
Caspi earned her ScD at the Harvard University School of Public Health, where she studied the social determinants of health. Socioeconomic factors – like income, neighborhood, and education- can play a major role in disease risk.
At Harvard, Caspi studied the food environment of low-income housing residents in the greater Boston area.
“Some of the most salient and important things we saw in that study were related to a lack of healthy food access and diet,” Caspi says.
Social determinants of health influence where people buy food and what kinds of food they buy. Individuals without financial or physical access to affordable healthy options are at a much greater risk for a host of diseases, including obesity.
“It became really hard to unsee the upstream factors influencing health,” Caspi says. “It became very clear that was where I wanted to invest myself as a researcher.”
Caspi’s work is inherently multidisciplinary. Obesity and food security are complex issues that require multiple research angles and community support to address.
“You’re not going to change systems that have been established over decades on your own,” Caspi says. “It requires collaboration.”
But collaboration comes with challenges.
“You can’t be impatient,” Caspi says. “Being impatient is fundamentally at odds with doing really good partnership-based work. You have to slow things down, and when you don’t slow things down the work suffers.”
Caspi emphasizes that she and others in the field likely will never find the “magic bullet” to solve these problems
“It’s detective work,” Caspi says. “There’s never going to be a day when we wake up and have a simple answer.”
Caspi says research is often a slow process, but it is the only way to build an evidence base with the capacity to help people.
While completing postdoctoral work at the University of Minnesota, Caspi used community-based research methods to contribute to the development of an intervention for food pantries. In the SuperShelf initiative, a team of core partners worked directly with local food pantries to help them develop a welcoming environment filled with fresh, healthy choices.
The fragmented hunger relief system had long been an overlooked area for research. Yet, Caspi found they are a highly utilized resourced. More than half of the people she surveyed during this work got the majority of their food from the pantry.
“That blew me away,” Caspi says. “I really understood the huge potential of this system to contribute to health and the role it was playing in getting food onto the table for many families.”
SuperShelf evaluated the impact of factors such as store layout and the best ways for pantries to spend their limited budgets. The pilot study found that when healthy food at pantry was rearranged so that, for example, produce was at the front of the pantry, clients were more likely to take it.
It is critical for interventions like SuperShelf to actively engage community partners, like the pantries, to make sure the work is actually serving their needs and working within their bounds.
“It makes me so much more proud of the work when I can stand up there with partners who co-created it,” Caspi says. “I, as the researcher, didn’t have to do any convincing to proceed with the work, and that felt really good.”
In 2017, Caspi received a five-year grant from the National Institutes of Health to expand the project. Given its initial success, many other food pantries wanted to participate. 62 food pantries applied for just 16 spots in the study.
It makes me so much more proud of the work when I can stand up there with partners who co-created it — Caitlin Caspi
Caspi is also working on a study about the impact of increasing the minimum wage on diet and health. The study is comparing communities in Minneapolis, Minnesota, where the City Council voted in 2017 to gradually increase minimum wage to $15 an hour by 2024, and Raleigh, North Carolina, where the minimum wage is $7.25 an hour, the same as the federal minimum wage.
The NIH-funded study will examine how raising the minimum wage impacts shopping behavior, food insecurity, and weight outcomes through measures collected over five years. Researchers are also conducting interviews about community members’ lived experiences.
While there have been many economic studies about the potential impacts of raising the minimum wage on the state and federal level, this type of prospective and comprehensive analysis of its impact on diet and health is rare.
Like Coming Home
Caspi joined the UConn faculty in 2020. She had been following the Rudd Center since her days in graduate school.
“I always had my eye on their work,” Caspi says. “I was always in awe of their trailblazing efforts and the resources they were contributing to the field.”
When the opportunity to come to UConn arose, Caspi was eager to join the team of preeminent researchers. The move also brought Caspi, who grew up in New Haven, closer to home.
By working at the Rudd Center and in the Department of Allied Health Sciences, both of which have nationally and internationally recognized faculty, Caspi is expanding her world of research connections and collaborators, which has always been central to her work.
Caspi hopes her future research will expand its focus on upstream policy factors, like minimum wage, that impact health and diet.
“It’s not the first thing you think of when you think of food policy,” Caspi says. “But in so many ways what we earn is connected to what we buy which is connected to what we can eat.”
Caspi sees her work as part of a growing movement toward equity in health. One of the most important understandings for Caspi’s work is that unknowns are going to be a big part of working for that mission.
Pioneering research may start a thread someone else might pick up and use to enact real change for people. But for that to happen, someone needs to start the work.
“It’s really okay to not have all the answers,” Caspi says. “It’s really okay to be a pioneer. It’s okay to just be taking the first step. It’s okay to try things out no one’s done before. That’s a great reason to do it, not a reason not to.”